Healthcare Provider Details

I. General information

NPI: 1992793947
Provider Name (Legal Business Name): WILLIAM HAROLD DICKHONER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 CEREAL AVE
HAMILTON OH
45013-2784
US

IV. Provider business mailing address

5220 BELFORT RD STE 130
JACKSONVILLE FL
32256-6017
US

V. Phone/Fax

Practice location:
  • Phone: 513-867-3166
  • Fax: 513-867-2056
Mailing address:
  • Phone: 904-446-3451
  • Fax: 904-446-3013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number35-05-1982-D
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35-05-1982-D
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number35.051982
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: